Keeping Employees' Emergency Skills Current

Refreshers and regular drills are essential for ensuring workplace safety.

By Steve Rieve

Jun 01, 2015

Olympic track and field great Jesse Owens succinctly described the necessity of effective training for his sport, but he might have easily been talking about training to counter a workplace emergency: "A lifetime of training for just ten seconds," he said.

To make those 10 seconds truly count when a person's life hangs in the balance, employees must be ready to act. Employees trained to respond to a medical emergency in the workplace can make all the difference between life and death.

"If an emergency occurs during the workday, our associates are our first responders," said Tracy Fagan Duffy, senior vice president of strategic operations at Natixis Global Asset Management. "We need them to act swiftly and accurately to ensure the best possible outcome."

But employees need regular practice and employers need to instill a culture of safety. Waiting for the first emergency to apply their knowledge and skills under pressure is a risky proposition.

One key factor employers must bear in mind is that people lose emergency skills quickly unless they are refreshed and repeated at regular intervals. This is true for first aid, CPR, or even AED use. When the goal is readiness to save lives, it is essential that employees engage in regular training where the core principles of basic training are continually repeated and revisited. CPR skills begin to decline as soon as two weeks after training, rendering 87 percent of trained employees ineffective at CPR within six months of certification, according to research from The Journal of Acute and Critical Care and BMJ.

Skill loss and how to prevent it is an ongoing issue for researchers in the field. In a 2008 study conducted by the University College of the Fraser Valley in British Columbia, scientists documented the post-certification decline of knowledge and skills in a cohort of first aid- and CPR-trained industrial employees. Although retention varied depending on the whether first aid or CPR was being tested, researchers found that "repetition may be more important than 'days since last trained.' For example, a person who trained 90 days prior to testing who was recertified seven or more times outperformed those who were only certified once previously on most tasks." They concluded that "repeated exposure to simplified messages throughout the year may be a simple, cost effective and efficient way to preserve CPR skills in those who are required to respond to emergencies in an occupational setting" and that "employers should be encouraging their first-aiders to refresh their knowledge between recertification and refresher courses."

Put another way, safety certification is only the beginning, said Joe Gray, who leads the Red Cross Instructor Training Academies. "It's not practical to assume that individuals will retain the same amount of knowledge and skills from their initial training in first aid or CPR/AED throughout the entire duration of the certification period," Gray said. "If we don't use it, we will lose it."

Enacting regular training into workplace safety programs ensures that employees review and retain the knowledge and skills they need to act if, and when, the time comes. "Multiple studies show the need for ongoing reviews and drills, and training keeps skills fresh and improves both accuracy and speed when performing this life-saving activity," said Grant Hansen, director of first aid/AED/CPR at the American Red Cross. "We strongly encourage employees who might be responding to a medical emergency to practice doing so, as a team, before the real emergency happens."

The industry's best training programs assist safety managers in structuring such refresher programs for employees. Regular drills help employees increase their speed and confidence in a true emergency and ensure that they keep skills alive. "Employees who work together and attend initial/review or refresher training as a group can benefit from bringing their 'real world' experiences from their workplace into the course," Gray said.

Employees who keep their skills and knowledge fresh by taking advantage of skill refreshers, online refreshers, or even workplace drills may be more confident in their ability to respond should an emergency arise. Gray considers information sharing in lunch and learns or monthly presentations to be a useful way of reinforcing safety as a concern in the workplace.

Natixis Global Asset Management organizes ongoing testing and drills, including an annual focus area such as shelter-in-place or active shooter with psychological resiliency training. In September, the company recognizes National Preparedness Month with a robust education and awareness campaign for all associates to reinforce key business continuity and emergency preparedness principles. And while Duffy said that Natixis is "thankful" that no emergencies have directly befallen its associates or facilities in the recent past, one of its associates, out for a walk at lunch, used his Red Cross training to help a pedestrian who had collapsed. "He rushed toward the victim, not away as many others did, and provided immediate first aid assistance until official first responders arrived," Duffy said.

Keeping the Training Current and Real
Companies with a culture of safety aim for systematic in-service training and training that is tailored to their particular industry and its hazards. Purolator International Inc., a Jericho, N.Y.-based parcel and freight delivery service, ensures that employees conduct annual safety drills and that they focus their skills on dangers specific to the trucking transport industry, such as trailer pull-away.

Keeping training current is a high priority for the company: "We have a learning management system which is automated," explained George Trapp, manager of security safety for Purolator International. "If there is mandatory training (i.e., TSA obligation and trailer pull-away), employees are reminded through our system, there is a reminder to take the required training. If they fail to do so, it's escalated to their managers. First aid is backed up, and we do audits to make sure everyone is current."

For Purolator International, training is not just about quantity, it's about quality. Training is as close to real life as possible. "We want to put stress on our trained people so they react almost automatically. People have to know instantly what to do if they have, for example, a cut femoral artery. They need to practice so it is root memory," Trapp said.

For Topgolf, a Dallas-based golfing entertainment company serving more than 4 million customers a year, keeping safety skills alive is about not just training, but also engagement. In the view of Helen Irizarry, director of safety and risk management for Topgolf, checking the box on safety training is never enough. "OSHA requirements are that you train these folks, but what does that mean? It may satisfy OSHA, but it doesn't satisfy me," she said. "OSHA requirements are incredibly important because they save lives. But I need to have this training done so that when it's finished, every associate at our site knows what to do when an emergency occurs."

Safety training must be more than a person at the front of the room delivering a PowerPoint presentation—it needs to excite employees, Irizarry said. Her answer is to keep training interactive. For starters, all new associates and all employees annually are taken around the site where they see where chemicals are stored and where safety equipment is located. In-service safety training includes hands-on activities, a culture that encourages questions, and random "live drills." The company also uses twice-daily pre-shift meetings between managers and employees to impart safety updates, such as reminders on procedure for a fire or extreme weather event. Irizarry’s goal is to ensure that skills and knowledge are embedded and every associate at a Topgolf site knows what to do when an emergency occurs.

As with Purolator, Topgolf ensures that training is tailored to the business. "Different departments have different training," she explained. "We go deeper" with an emphasis on industry-specific areas, such as the safe handling of maintenance chemicals and alcohol training as it affects golfing patrons. Topgolf keeps in-service training current and regular, with an AED management program and "hot schedules" that keep track of all training.

"Annual training is important, but constant reminders are equally important. If you just leave it at annual training, your associates won't be prepared in case of emergency," Irizarry explained.

Benjamin Franklin knew a thing or two about emergency preparedness. The Founding Father, scientist, and American iconoclast who started the first fire brigade in Philadelphia could have been writing about effective workplace training when he said, "Tell me and I forget. Teach me and I remember. Involve me and I learn."

This article originally appeared in the June 2015 issue of Occupational Health & Safety.

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